The foramen magnum in scaphocephaly

Childs Nerv Syst. 2022 Nov;38(11):2163-2170. doi: 10.1007/s00381-022-05624-2. Epub 2022 Aug 5.

Abstract

Purpose: The foramen magnum (FM) presents various alterations in craniosynostoses, such as brachycephaly or Crouzon syndrome. However, to date, no study has been devoted to its morphology and morphometry in scaphocephaly, which is the most common of cranial deformities resulting from premature fusion of cranial sutures.

Methods: We assessed the morphology and morphometry of FM using preoperative thin-cut CT scans of 107 children with non-syndromic sagittal craniosynostosis aged 1-12 months (mean age 5.38 months). A series of sagittal and transverse dimensions were taken and the FM area was calculated in each case. Obtained data were compared to the age-matched control group of 101 normocephalic children.

Results: Dolichotrematous type of FM was dominant in the scaphocephaly group and observed in 63/107 cases (58.9%). The mean FM area in the scaphocephaly group was 519.64 mm2 and was significantly smaller compared to the control group (p = 0.0011). The transverse diameter and anterior sagittal diameter were also significantly smaller (p = 0.0112 and p = 0.0003, respectively).

Conclusion: The area of FM in scaphocephaly is smaller compared to normal individuals. This is associated with a significant reduction of the width of FM in children with sagittal craniosynostosis. FM in scaphocephaly is larger than in other reported series of children with brachycephaly or Crouzon syndrome.

Keywords: Children; Craniosynostoses; Foramen magnum; Occipital bone; Scaphocephaly; Skull base.

MeSH terms

  • Child
  • Cranial Sutures
  • Craniofacial Dysostosis* / complications
  • Craniofacial Dysostosis* / diagnostic imaging
  • Craniofacial Dysostosis* / surgery
  • Craniosynostoses* / complications
  • Craniosynostoses* / diagnostic imaging
  • Craniosynostoses* / surgery
  • Foramen Magnum / diagnostic imaging
  • Foramen Magnum / surgery
  • Humans
  • Infant
  • Skull
  • Tomography, X-Ray Computed / methods